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Have you ever felt dizzy or lightheaded when you stand up? You might have a condition known as orthostatic hypotension, where your blood pressure drops too quickly when you stand up. It may seem like a harmless head rush, but it can sometimes represent an underlying issue. Read on to know what orthostatic hypotension is, its causes, symptoms, available treatment options, and how chiropractic care in Singapore helps.
What is Orthostatic Hypotension?
Orthostatic hypotension is also known as postural hypotension. It is a condition that causes a sudden decrease in blood pressure when you move from lying down or sitting to standing upright. This abrupt fall in blood pressure occurs within 3 minutes of standing. It is defined by a drop of at least 20 mmHg in systolic and 10 mmHg in diastolic pressure.
Normally, when we stand up, the blood pools in the lower parts of the body due to gravity. This reduces the amount of blood returning to the heart, which, in turn, decreases cardiac output. As a compensatory mechanism, our bodies quickly adjust by constricting blood vessels and increasing heart rate. This helps maintain stable blood pressure and ensures an adequate amount of blood flow to the brain and the other body parts.
In orthostatic hypotension, this compensatory mechanism is delayed, which leads to a sudden drop in blood pressure and a decrease in blood flow. As a result, symptoms like fainting and dizziness appear. This condition is more common among older adults and can range from mild to severe forms.
Orthostatic Hypotension Causes
This condition can be temporary or chronic and can stem from various factors. Some of the known causes of orthostatic hypotension include:
● Dehydration
One of the most frequent reasons for orthostatic hypotension is dehydration. It can occur as a result of insufficient fluid intake, excessive sweating, diarrhea, vomiting, or fever. This reduces blood volume, which affects your body’s ability to maintain blood pressure upon standing.
● Medications
Some medications, such as antihypertensives, diuretics, vasodilators, antidepressants and anti-Parkinsonian drugs, can affect your body’s ability to maintain blood pressure. Their inappropriate use or overdose can increase the risk of orthostatic hypotension.
● Nervous System Disorders
Diseases that impair the autonomic nervous system, which controls the regulation of blood pressure, can cause orthostatic hypotension. Examples include diabetic nephropathy, Parkinson’s disease, and autonomic neuropathy.
● Age-related Changes
Older adults are more likely to be affected by orthostatic hypotension. As you age, the function of the autonomic nervous system and the elasticity of your blood vessels decrease. This makes it difficult for the body to regulate blood pressure.
Orthostatic Hypotension Risk Factors
Certain risk factors increase your chance of developing orthostatic hypotension. These include:
- Prolonged bed rest or periods of inactivity
- Pregnancy
- People aged 65 and older
- Anemia
- Heat Exposure
- Heart problems
- Endocrine disorders, such as thyroid disease or adrenal insufficiency
- Excessive alcohol consumption
- Eating heavy meals
Orthostatic Hypotension Symptoms
When your blood pressure falls upon standing, it decreases blood flow to the brain and other parts of the body. As a result, the following symptoms appear.
- Dizziness
- Light-headedness
- Syncope (fainting)
- Fatigue
- Headache
- Blurred vision
- Nausea
- Palpitations
- Confusion
- Legs buckling
These symptoms usually go away when you sit or lie down for several minutes. If you often experience these symptoms, seek medical help.
Complications of Postural Hypotension
Orthostatic hypotension, if left untreated, can lead to some serious complications that can impact your quality of life. These include:
- Increased risk of bone fracture and other injuries from falls
- Cognitive impairment, such as confusion, memory problems, or difficulty concentrating due to reduced blood flow to the brain.
- Postprandial hypotension (low blood pressure after eating a high-carbohydrate meal)
- Increased risk of stroke due to fluctuation in blood pressure
- Organ failure or shock if your blood pressure drops too low
- Supine hypotension (low blood pressure when you lie down)
- Increased risk of cardiovascular conditions
Orthostatic Hypotension Diagnosis
Your healthcare professional will conduct a physical examination, review your medical history, and order some tests to diagnose the cause and determine the treatment for your condition. He might ask about your symptoms, when, and how often they occur. He may inquire about your existing health condition, medications, and lifestyle choices that may contribute to blood pressure changes.
He might recommend the following
● Blood Pressure Monitoring
This is the primary diagnostic step that involves measuring systolic and diastolic pressure while lying down, sitting and standing. A drop of 20 mmHg in systolic blood pressure and a drop of 10 mmHg in diastolic pressure within 3-5 minutes of standing suggests orthostatic hypotension.
● Blood Tests
Blood tests can check if you have hypoglycemia or anemia (low volume of red blood cells). Both can cause orthostatic hypotension.
● Electrocardiogram (ECG)
It measures the electrical activity of your heart and reveals abnormalities in cardiac rhythm.
● Tilt Table Test
The tilt table test is used to check how your body responds to a change in position. In this test, you will lie flat on the table that tilts to lift your upper part of the body. Your healthcare professional will note down your blood pressure when the table is tilted.
● Autonomic Function Tests
Your healthcare professional will order some tests to evaluate the ability of your autonomic nervous system to control blood pressure.
● Stress Test
Your doctor might order a stress test if he suspects that underlying conditions, such as arrhythmia and heart failure, are responsible for fluctuations in blood pressure. This test measures your heart function under physical exertion.
Orthostatic Hypotension Treatment
Orthostatic hypotension’s management involves a combination of lifestyle modification, medication adjustments, and therapies tailored to the underlying cause. The goal is to improve the regulation of blood pressure and decrease your symptoms.
Lifestyle modification
The following lifestyle modifications will help ease your symptoms. These include:
- Increase Fluid and Salt Intake: Staying well hydrated is important for your body to function properly. Drinking water increases your blood volume, and adequate salt intake helps raise blood pressure.
- Avoid Sudden Changes in Posture: Move slowly when you change your posture from lying or sitting to standing, as it helps adjust your body and prevents dizziness.
- Compression Stockings: Your doctor might suggest wearing compression stockings or abdominal binders. It helps prevent pooling of blood in the lower body and supports better circulation.
- Elevate the Head of the Bed: Raised head decreases the sudden drop in blood pressure upon waking.
- Exercise: Gentle physical activity helps strengthen your leg muscles and prevent pooling of blood. Try to avoid exercising in humid and hot weather.
- Limit Alcohol Consumption: Excessive alcohol intake can lead to dehydration and worsen orthostatic hypotension. So limit alcohol or avoid it completely.
- Avoid Triggers: Limit exposure to heat and avoid heavy meals as they can trigger orthostatic hypotension.
Medication Management
You might be taking certain drugs that cause orthostatic hypotension, such as diuretics and beta blockers. Your physician or pharmacist will review these medications and either adjust the dose or change these drugs.
Symptoms of mild orthostatic hypotension go away on their own when you lie down immediately. For severe cases, your doctor might recommend some medications depending on your condition. These may include:
- Fludrocortisone
- Midodrine
- Droxidopa
- Pyridostigmine
- Erythropoietin
How Chiropractic Care Can Help People With Orthostatic Hypotension In Singapore?
Chiropractic care can effectively help people manage orthostatic hypotension. It can support overall nervous system health and improve symptoms associated with blood pressure regulation issues.
Orthostatic hypotension may occur as a result of dysfunction in the autonomic nervous system, which controls involuntary functions of the body, such as heart rate and blood pressure. Our spine is made up of 33 vertebrae, and it houses the spinal cord, a critical part of the nervous system.
When the vertebrae are misaligned (subluxations) even slightly by an inch, it disturbs the nerve signalling between the brain and body. This may lead to poor regulation of blood pressure. Chiropractic adjustments help restore alignment of the spine, improve nerve signaling, and restore communication between neurons and body tissues.
By improving spinal alignment, chiropractic care also restores autonomic nervous system regulation. This helps improve regulation of blood pressure, thus preventing symptoms, like dizziness and lightheadedness. Further, your chiropractor may recommend specific exercises, ergonomic adjustments, and tips for posture improvement to reduce blood pooling in the lower extremities.
At Vitality Chiropractic Centre in Singapore, our experts specialize in Upper Cervical Chiropractic Care. Our clinic is the first of its kind in Singapore, focusing on the upper cervical region to address a variety of health issues. We believe that proper spinal alignment is the key to a person’s health and well-being. Our team provides personalized care plans tailored to your individual needs. So what are you waiting for? Contact us right now!
References
- Ringer M, Hashmi MF, Lappin SL. Orthostatic Hypotension. [Updated 2025 Jan 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448192/
- Jennifer Tran, Sarah L Hillebrand, Carel G M Meskers, Rebecca K Iseli, Andrea B Maier, Prevalence of initial orthostatic hypotension in older adults: a systematic review and meta-analysis, Age and Ageing, Volume 50, Issue 5, September 2021, Pages 1520–1528, https://doi.org/10.1093/ageing/afab090
Call 8438 9550 or email help@vitalitychiropracticcentres.com today!
Meet Our Chiropractor Specializing in Orthostatic Hypotension Care in Singapore
Dr Shaan (Traditional and Complimentary Therapy Qualification) is a Chiropractor from London (UK) who graduated from the Anglo-European College of Chiropractic (UK) as a Doctor of Chiropractic (not medical doctor or dentist). He has completed post-graduate studies and has been serving patients in Singapore since 2015.
He founded Vitality Chiropractic Centres to open the first Upper Cervical clinic in Singapore, and the only practicing Knee Chest Upper Cervical Technique in South East Asia.
He is the Alliance of Chiropractic (AoC) Chairman for Outreach, organising events within Singapore with the People’s Association and other charities. Shaan has served thousands of patients, with experience in patients with headaches, migraines, vertigo, Meniere’s, trigeminal neuralgia, whiplash, IBS and other chronic nervous system problems.
Dr Jessey (黄钰心矫正师) (Traditional and Complimentary Therapy Qualification) is a Chiropractor from Kuala Lumpur (Malaysia), graduated from Anglo-European College of Chiropractic (UK) as a Doctor of Chiropractic (not medical doctor or dentist). She has experience serving patients from 2 weeks old to 96 years old prior to moving to Singapore and joining Vitality Chiropractic (活力脊椎矫正中心).
She has completed post-graduate studies and is Singapore’s first female Upper Cervical Chiropractor (上颈椎矫正护理).
Jessey is active in outreach, participating in charitable trips to Cambodia and within Singapore. Jessey has experience helping patients with headaches, migraines, dizziness (眩晕/头晕), Meniere’s (美尼尔氏综合症), slipped disc, anxiety, fibrillations, IBS and other chronic nerve system problems. She also has a special interest in children and younger patients.
If you’ve been struggling with Persistent Postural-Perceptual Dizziness, call 8438 9550, email help@vitalitychiropracticcentres.com or fill in your information below to book your appointment.
Chiropractic Care for Orthostatic Hypotension
Treatment Rates in Singapore
Here are the expected Rates Orthostatic Hypotension in Singapore Dizziness care services at Vitality Chiropractic centres.
Discovery Call
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Jump on a call to discuss your concerns and determine if we are the right fit for you.
Consultation
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During the initial consultation, we will run a physical examination, postural assessment, and nerve system test.
Test Results
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Our chiropractor will explain the findings and test results from the consultation. A customised care plan will then be developed for you.
Single Session
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We will perform a nerve scan and adjustment as needed. Re-examinations and rehab exercises might be implemented.
Written by
Shaan Rai (Chiropractor, Singapore)
Shaan is a British Chiropractor, based in Singapore. He is an Alliance of Chiropractic (AOC) registered Singapore Chiropractor, completing a 5 year course at AECC (UK), attaining his Masters in Chiropractic. He is the Vice President and Chairman for Outreach & Charity for Alliance of Chiropractic (AOC) and is the founder of Vitality Chiropractic Singapore. He developed the NeuroPro method, combining Upper Cervical techniques with Functional Neurology Rehab, with published research coming in 2025.
Dizziness Research in Singapore
Read our case report about our patient with dizziness and hearing loss, and the improvements seen with our care. This was produced by the Australian Spinal Research Foundation, and published in the Asia-Pacific Chiropractic Journal.
Read Our Book
Shaan authored the book, ‘Dealing With Dizziness – Holistic Solutions For Unexplained Chronic Dizziness, Vertigo, and Balance Problems’.
You can find it on Amazon, or available in our Singapore Chiropractic clinic.
FAQS
Chiropractors are trained doctors of Chiropractic. They train exclusively as doctors of Chiropractic, not as medical doctors or dentists.
This is the same as how a Dentist, TCM or PhD graduate are trained as doctors in their field, but are also not medical doctors.
If you have any previous scans, x-rays, MRI’s or other imaging, please bring them to your appointment. We would also recommend bringing a family member or friend if you need support or to discuss finances.
Your initial Consultation will take approximately 1 hour, your Results will take approximately 45 minutes and follow up Appointments will take 20-35 minutes depending on your case.
After Chiropractic adjustments there can occasionally be side effects. The most common feelings after corrections (especially in the beginning) are:
- No changes yet
- Some stiffness in the muscles or light soreness
- Feeling relief
If there are any other symptoms or sensations experienced, please ensure to consult with your Chiropractor.
Absolutely! If you book using our online system you should get an email immediately then a WhatsApp confirmation from our staff.
For follow up appointments you should receive an email 48 hours before your appointment. If you do not, and you would like reminders, please let us know and we will be able to help. If you receive reminders but do not want to, you can also opt out of these emeails.
On any day you receive an adjustment we would advise taking it easy and drinking plenty of water. Give it at least 2 hours before exercising. If you feel tired then listen to your body and get to sleep early. Upon starting care, we will share a guide for you to take home, with a long list of do’s and don’ts, so you can take an active part in your care.
We recommend wearing something comfortable that you can bend in. While you don’t need to wear gym clothes, clothes which you can move in freely will be helpful for any tests or techniques the doctor will need to perform. For women, if you are wearing a dress or skirt we will provide blankets to cover you.
Chiropractic, and any health approach, will not be the answer for every patient and every health concern. Other Chiropractors may use different techniques and methods which may not produce the same results as Upper Cervical Chiropractic.
Our Chiropractors conduct a thorough history, physical assessment, nerve scans and biomechanical x-rays to determine if this is a case they can help.
If we are not the right fit for you, we will do our best to find the right practitioner for you.
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